How was your experience with Robert Gustofson at CCRM Colorado?
Dr. G is young-ish (I'd say early 40s). He is a nice man and clearly strives to be compassionate towards his patients. He is very knowledgeable and I rarely felt that a question I had that wasn't answered to my satisfaction. He goes into each consultation with lots of information, so usually most of my questions were answered by his initial spiel. We picked him because we wanted to go with CCRM and heard that he had a better bedside manner than Schoolcraft or Surrey. Overall, I'm happy with our choice.
What's one piece of advice would you give a prospective patient of Robert Gustofson at CCRM Colorado?
This may sound a little strange, but come armed with some ice-breaker small talk before your initial consultation appointment. The first time we met with him, he tried to ask us questions to break the ice, but we were so tired, overwhelmed, and nervous that his attempt fell flat as a pancake. He clearly really wants to connect with his patients and make sure their experience is pleasant, but he's not a super gregarious guy. We like him, but have never felt a great rapport and I wonder if we would feel differently if we had been able to make a personal connection during this first visit. Also - this is true of all CCRM doctors - but you won't see him much. But, if you have questions, he's very good about responding to emails. He's responded to all of my email questions within 24 hours.
During treatment, were you treated like a number or a human with Robert Gustofson at CCRM Colorado?
Dr. G is a very nice man and a good doctor. He acknowledges the emotional piece of the process and has shared with us that he and his wife did IVF to conceive their first child. I still haven't felt an amazing rapport with him, but that's partly because most of our interactions at CCRM are with the nurses, not the doctor.
UPDATE: Since doing two egg retrievals and one (successful) FET with Dr. G, I began to feel more of a rapport. You see the doctor more often during the IVF process and he calls personally with results of CCS testing. I found him to be empathetic and caring during the IVF process.
Describe the protocols Robert Gustofson used in your cycles at CCRM Colorado and their degree of success.
I have unexplained infertility, with the only known issue is a short luteal phase. We started out with Clomid + IUI (including HCG trigger shot and progesterone support). He explained that Clomid works better than Femara for short luteal phase. He gave us a 40% chance that IUI would work over the course of 3 cycles. We never had a positive pregnancy test from the IUIs.
We then moved on to IVF. He recommended ICSI to give us the best odds of fertilization (since we've never had a positive pregnancy test and don't know where the problem is occurring). He also recommended CCS testing followed by an FET given my age (38) and to give us the best odds of a pregnancy the first time around. He predicted that one cycle of IVF would yield 6 embryos, 3 of which would be CCS normal.
Our first egg retrieval, we did estrogen priming with Protocol 3 and a lupron trigger shot. We ended up with 14 eggs, 9 mature, 6 fertilized, 3 blastocysts, and one CCS normal. In our regroup, he explained that he was surprised by our results, but suspected that it was probably a pattern that it explained why I hadn't gotten pregnant naturally. It took a year's worth of eggs in perfect laboratory conditions to get one viable embryo.
We decided to do a second IVF cycle to bank more embryos, because ideally we want two children. He switched the protocol for this next one in the hopes of getting more eggs/embryos, and noted that this part of the process was more art than science. We did testosterone priming and microdose lupron flare (protocol 6). This cycle was much more exciting and dramatic! At my first follicle check, one follicle had shot way ahead and was already over 20mm! After this, he told me to stop the microdose lupron and added ganorelix to keep me from ovulating. Ultimately, we let the lead follicle "go" and waited for the others to reach a good size. This time we did an HCG trigger shot, which I think helped a ton with egg maturity. We got 22 eggs, 13 mature, and 12 fertilized. 6 made it to blast this time, but, alas, only one was CCS normal. In some ways, the second retrieval seemed way more successful, but the ultimate result was the same as the first. This experience confirmed that there was definitely a pattern of something wrong with my eggs (or possibly the combination of my eggs and my husband's sperm). Even though it wasn't the result we wanted, I felt relieved to find out what was going on.
Rather than bank more embryos, we moved on to an FET, which fortunately was successful on the first attempt! I don't think we did anything special - just the standard month of birth control pills, followed by estrogen patches, vaginal estrace, vaginal progesterone (endometrin), and progesterone in oil injections. The vaginal estrace was added once it was determined that my lining was borderline too thin. Those drugs continued until we started weaning after our 8.5 week ultrasound.
Describe your experience with your nurse at CCRM Colorado. (Assigned nurse: Chris)
I love our nurse Chris! She is peppy, kind, and genuine. You don't always get to speak to your assigned nurse, but overall I've had a good experience with most of the nurses I've interacted with. I didn't run into any problems with communicating - everyone emails or calls back in a short amount of time. And for the most part, the nurses all have positive attitudes, which makes a huge difference given how difficult and emotional this process is.
Describe your experience with CCRM Colorado.
CCRM is one of the best in the business and is a well-oiled machine. I rarely feel like "just a number." This may be because I go to the Louisville clinic, which is smaller and less "fertility industrial complex" seeming than the Lone Tree office. This is the only clinic I've been to, so I don't have much to compare it to. However, based on things my friends have said about their experiences with other clinics, I think CCRM does a particularly good job of managing expectations. You will have to undergo all of their testing even if you've done some of it before. This is part of the well-oiled machine piece. And, they won't start treatment until all testing is done. This felt a little frustrating at first, but I respect that they want to be thorough before they decided on treatment options.
The main issue I've had with the Louisville office is going in for blood draws. For example, I would call and let them know I needed my thyroid levels re-checked and schedule an appointment. When I got there, the phlebotomist was prepared to test for something other than my TSH. What was happening is that the receptionist just scheduled "blood draw" and then the nurses were guessing what I might need given my chart and calendar, and they didn't always guess right. Any time you get a blood draw, be sure to check the label that it's for the right thing! I know this issue has been brought up, but I'm still running into this problem. The best solution is to tell the receptionist to make a "phone note" about what the blood draw is for and then double-check the blood draw label when you go in.
Describe the costs associated with your care under Robert Gustofson at CCRM Colorado.
I think the initial testing was $4K; we spent around $5-6K on three IUIs. We spent about $50-60K for two rounds of IVF/ICSI/CCS and one FET (including medications).
Describe Robert Gustofson's approach to eSET (elective single embryo transfer) vs. multiple embryo transfer at CCRM Colorado.
Dr. G recommended single embryo transfer because we will be doing CCS. He said the odds of a pregnancy after transferring one chromosomally normal embryo would be 65-70%. If we were to transfer two, our odds would go up to 80%, but the risk of twins would be 60%.
We were concerned about the risk of twins (and preferred to use our only 2 embryos to try for two, non-twin siblings) so we went forward with the eSET, which was successful.
What specific things went wrong at CCRM Colorado?
- Failed to call in prescriptions to pharmacy
- Lost appointments
- Failed to call with results
Describe the specific things that went wrong at CCRM Colorado.
- Once I had an ultrasound in Lone Tree over the weekend and they scheduled me for a follow-up ultrasound in Louisville the following Tuesday. When I showed up, they had no record that I was supposed to come in that day. However, they had no problem squeezing me and were flexible and gracious about it.
- Once a prescription for thyroid meds was called into a specialty fertility pharmacy instead of my local drug store. I had to call and ask them to call it into the right place, but it ended up being no big deal.
- My husband and I both got tested for communicable diseases. They emailed him with his results, but did not give me mine until I called to follow up a week later.
- Several times I've made appointments for blood draws (to re-check my TSH) and there was a miscommunication about what they were supposed to be testing for.